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    • Abstract
      In dermatology probiotic microorganisms have primarily been used orally for the prophylaxis and treatment of atopic disorders. In contrast to the successes achieved for gastrointestinal disorders, positive effects for atopic dermatitis only have been found in a few studies. New insights could now fundamentally change the impact of probiotics on dermatology. Probiotics are - like microflora of the skin - non-pathogenic microbes, which do not induce inflammatory responses in the skin. Common pathways for probiotics, non-pathogenic microbes, and microflora are characterized, in order to facilitate their more effective therapeutic use. These microbes display a majority of their effects directly at the site of application and thereby induce natural defense mechanisms. However, promotion of immunological tolerance is just as important in producing positive effects. Tolerance of the resident flora on surface organs developed during evolution and the mechanisms of action are multifaceted. Therefore, the topical application of probiotics and non-pathogenic microbes for prophylaxis and therapy of overwhelming cutaneous pro-inflammatory immune reactions is very promising. Results of recent clinical trials already have demonstrated the efficacy of this new therapeutic concept. Hautarzt. 2009 Oct;60(10):795-801. doi: 10.1007/s00105-009-1755-8.
      Outside-in. Probiotic topical agents.
      Volz T, Biedermann T.
    • Abstract
      INTRODUCTION AND OBJECTIVE:
      Normal human skin can produce a range of antimicrobial chemicals that play an important part in eliminating potential cutaneous pathogens. Lactobacillus plantarum is a gram-positive bacteria that produces antimicrobial peptides, which when applied to the skin can act like an anti-inflammatory as well as enhance the antimicrobial properties of the skin. Clinical studies were conducted to determine the effect of lactobacillus extract on improvement of skin barrier and reduction of erythema from chemical irritant, skin microflora, and acne. Results show that lactobacillus extract was effective in reducing skin erythema, repairing skin barrier, and reducing skin microflora, thereby exhibiting an effective reduction in acne lesion size and erythema at 5%, but not at 1%.
      CONCLUSION:
      Based on the results of these studies, lactobacillus extract (5%) can be used to treat mild acne lesions. J Cosmet Sci. 2012 Nov-Dec;63(6):385-95.
      Physiological effect of a probiotic on skin.
      Muizzuddin N, Maher W, Sullivan M, Schnittger S, Mammone T.
    • Related Articles Mindfulness-Based Cognitive Hypnotherapy and Skin Disorders. Am J Clin Hypn. 2018 Jul;61(1):34-44 Authors: Shenefelt PD Abstract
      Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Meditation, including mindfulness meditation, and hypnosis both utilize trance phenomena to help produce focalization and specific improvements in skin disorders through psycho-neuro-endocrine-immunologic mechanisms. Hypnosis, cognitive hypnotherapy, focused meditation, and mindfulness meditation are discussed with respect to improving various skin disorders including acne, acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythema nodosum, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, prurigo nodularis, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Their integration into mindfulness-based cognitive hypnotherapy is then discussed and illustrated with improvement in a patient with systemic lupus erythematosus.
      PMID: 29771216 [PubMed - in process] {url} = URL to article
    • Related Articles Assessment of rosacea symptom severity by genome-wide association study and expression analysis highlights immuno-inflammatory and skin pigmentation genes. Hum Mol Genet. 2018 May 16;: Authors: Aponte JL, Chiano MN, Yerges-Armstrong LM, Hinds DA, Tian C, Gupta A, Guo C, Fraser DJ, Freudenberg JM, Rajpal DK, Ehm MG, Waterworth DM Abstract
      Rosacea is a common, chronic skin disease of variable severity with limited treatment options. The cause of rosacea is unknown, but it is believed to be due to a combination of hereditary and environmental factors. Little is known about the genetics of the disease. We performed a genome-wide association study (GWAS) of rosacea symptom severity with data from 73,265 research participants of European ancestry from the 23andMe customer base. Seven loci had variants associated with rosacea at the genome-wide significance level (p≤5 × 10-8). Further analyses highlighted likely gene regions or effector genes including IRF4 (p=1.5 × 10-17), an HLA region flanked by PSMB9 and HLA-DMB (p=2.2 × 10-15), HERC2-OCA2 (p=4.2 × 10-12), SLC45A2 (p=1.7 × 10-10), IL13 (p=2.8 × 10-09), a region flanked by NRXN3 and DIO2 (p=4.1 × 10-9), and a region flanked by OVOL1and SNX32 (p=1.2 × 10-8). All associations with rosacea were novel except for the HLA locus. Two of these loci (HERC-OCA2, SLC45A2) and another precedented variant (rs1805007 in MC1R) with an association p value just below the significance threshold (p=1.3 × 10-7) have been previously associated with skin phenotypes and pigmentation, two of these loci are linked to immuno-inflammation phenotypes (IL13, PSMB9-HLA-DMA) and one has been associated with both categories (IRF4). Genes within three loci (PSMB9-HLA-DMA, HERC-OCA2, and NRX3-DIO2) were differentially expressed in a previously published clinical rosacea transcriptomics study that compared lesional to non-lesional samples. The identified loci provide specificity of inflammatory mechanisms in rosacea, and identify potential pathways for therapeutic intervention.
      PMID: 29771307 [PubMed - as supplied by publisher] {url} = URL to article
    • TEAE percentage rate is low with oxymetazoline treatment for rosacea. For more information. 
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